Health knowledge and the impact of social exclusion on young people with intellectual disabilities.

BACKGROUND: Cognitive impairments are often assumed to underlie individuals' difficulties with understanding health issues. However, it was predicted that socially excluded individuals would have greater difficulty gaining understanding of sensitive topics related to sexuality than other public health messages, such as alcohol use. METHOD: The health knowledge of 31 typically developing young people, 29 young people with mild intellectual disabilities (ID) and 23 participants with physical disabilities but no cognitive impairments was compared. RESULTS: The largest group differences were related to more private and personal health issues, such as pregnancy/contraception. Both groups of young people with disabilities had less knowledge of pregnancy/contraception than their non-disabled peers. Thus, deficits in this sexual knowledge did not just appear to be the result of cognitive deficits. CONCLUSIONS: The findings suggest social exclusion may contribute to young people with intellectual disabilities' poorer knowledge of pregnancy and contraception. The results have implications for interventions.

Positive PsychoTherapy in ABI Rehab (PoPsTAR): A pilot randomised controlled trial.

Psychological distress is common following acquired brain injury (ABI), but the evidence base for psychotherapeutic interventions is small and equivocal. Positive psychotherapy aims to foster well-being by increasing experiences of pleasure, engagement and meaning. In this pilot trial, we investigated the feasibility and acceptability of brief positive psychotherapy in adults with ABI and emotional distress. Participants were randomised to brief positive psychotherapy plus usual treatment, or usual treatment only. Brief positive psychotherapy was delivered over eight individual out-patient sessions, by one research psychologist. A blinded assessor administered the Depression Anxiety Stress Scales (DASS-21) and the Authentic Happiness Inventory (AHI) at 5, 9 and 20 weeks post-baseline. Of 27 participants randomised (median age 57; 63% male; 82% ischaemic stroke survivors; median 5.7 months post-injury), 14 were assigned to positive psychotherapy, of whom 8 completed treatment. The intervention was feasible to deliver with excellent fidelity, and was acceptable to participants. Retention at 20 weeks was 63% overall. A full-scale trial would need to retain n = 39 per group to end-point, to detect a significant difference in change scores on the DASS-21 Depression scale of 7 points (two-tailed alpha = .05, power = .80). Trials including an active control arm would require larger sample sizes. We conclude that a full-scale trial to investigate efficacy is warranted.

Sexuality and sex education of adolescents with intellectual disability: mothers' attitudes, experiences, and support needs.

Few studies have considered families' views about adolescents' sexual development. The authors compared attitudes and behaviors of mothers of young people with (n = 30) and without intellectual disability (n = 30). Both groups placed similar importance on dealing with their children's developing sexuality and were similarly confident in doing so. Mothers of young people with intellectual disability held more cautious attitudes about contraception, readiness to learn about sex, and decisions about intimate relationships. Mothers expressed concerns about their children with intellectual disability and sexual vulnerability. They had also spoken about fewer sexual topics with their children and began these discussions when their children were older. The findings can inform more sensitive supports and materials to help families deal with the sexual development of their offspring.

Sexual understanding and development of young people with intellectual disabilities: mothers' perspectives of within-family context.

The sexual development of young people with intellectual disabilities is a marker of their transition to adulthood and affects their sense of well being and identity. Cognitive impairments and a socially marginalized position increase dependence on their families to assist with sexual matters. In this study, the authors adopted a novel interpretive phenomenological analysis approach, asking 8 mothers to contrast their experience of supporting similarly aged siblings with and without intellectual disabilities. Acknowledgment of their nondisabled offspring's sexuality was demanded by increasing autonomy, whereas continuing dependence of the offspring with intellectual disabilities hindered mothers who were addressing this intensely private and sensitive issue with them. The topic of sexuality brought to the forefront mothers' fears about their offspring's ability to cope with the challenges of adulthood.